Are Democrats (well, some of them) celebrating too soon? Could the health care bill have gotten 60 votes in the Senate only to be doomed to failure in the House, which much reconcile its own, more liberal version of the legislation with that passed by the Upper Chamber?
As Ramesh Ponnuru argues, there are certainly no guarantees. But if I were a conservative, I wouldn't be holding out more than a thin sliver of hope -- probably not more than a 10 percent chance -- that the bill could still be defeated.
The vote for the House's own version of health care reform was 220-215, meaning that the bill received only two more votes than the 218 required for passage. Nor is it necessarily true that there must be at least 50% + 1 votes in the House just because there were 60 in the Senate. The entirety of the House is up for re-election next year, versus just one-third of the Senate. And, although this is a truth somewhat obscured by the filibuster, the House actually has a slightly higher proportion of conservative Democrats than does the Senate.
With that said, the 60 votes in the Senate included members as conservative as Ben Nelson, as liberal as Bernie Sanders, as sanctimonious as Joe Lieberman, as idiosyncratic as Russ Feingold, and as electorally vulnerable as Blanche Lincoln. The reason they all voted for the bill is because they had no choice not to -- with no Republican support, a single defection on the cloture motion would have killed the measure.
In the House, by contrast, the members did have a choice; their individual 'nay' votes did not doom the package to failure. Moreover, they had powerful incentives to exploit this choice. The Democratic caucus seems to have concluded -- rightly I believe -- that failing to pass a health care bill would be injurious to the party as a whole. But that doesn't mean a yea vote is in the interest of each individual member -- especially those in conservative districts where the bill has become rather unpopular. The optimal outcome for a lot of Democrats is to have voted against a bill that passes anyway.
But this also implies that the votes of the 39 Democrats who voted against the bill are more malleable than they appear. If, as in the Senate, their votes really made the difference between success and failure, a goodly number of them might have voted for the package. It's not an accident, in other words, that the health care bill -- like the cap-and-trade bill -- passed the House with exactly enough votes and barely any more. It is, rather, something of the equilibrium outcome. (If the House instead had a standing rule that 55 percent -- meaning 240 -- of its members had to vote for legislation in order for it to pass, you'd probably have an equilibrium centered around 240 votes rather than 220.)
In some ways, indeed, the danger for the Democrats may not be that they have too little margin for error in the House but that they have too much. If Nancy Pelosi could create a credible ultimatum -- vote for this particular bill or else -- I suspect there would be quite a few different permutations of health care reform that would pass the House (subject to the constraint that the compromise would also have to be acceptable to the Senate).
For instance, is the Senate's language on abortion, which was crafted to satisfy Ben Nelson, truly unacceptable to Bart Stupak? In an ultimatum scenario, I suspect not. But likewise, if it was Stupak's language or else, would you see pro-choice Democrats willing to vote down health care? Again, probably not.
This is where Nancy Pelosi comes in; it's her job to sort out the competing ultimatums. This sorting-out process necessarily involves brinkmanship. Of course you're going to have pro-choice Democrats saying that Nelson's compromise goes too far, and Stupak saying it doesn't go far enough. Of course you're going to have House liberals saying that they've already compromised too much -- and Blanche Lincoln saying they hadn't dare budge from the Senate's version. This is normal -- and tells us almost nothing.
About the only meaningful thing I've read on the the House's next step in health care reform, rather, is Blue Dog Democrat Jason Altmire's assertion that "a lot of conservative Democrats who voted against it in the House would support the Senate bill as it comes out of conference." This confirms that Pelosi has some flexibility -- she has, I'm guessing, a playing field of perhaps 240 or 245 potential yes votes, from which she'll have to cobble together 218.
Fortunately for Democrats, Pelosi is very good at her job. I don't know exactly which 218 votes she'll get. And she probably won't get a lot more than 218. But the odds remain very high that she'll get them somewhere.